This proposal requests continued NIA funding for the Midcareer Investigator Award in Patient- Oriented Research (K24) to Dr. Kristine Yaffe. The overarching aims of this K24 renewal application are three-fold: 1) To perform rigorous patient-based research studies in a new direction aimed at the identification of the predictors of cognitive aging and structural brain integrity across the lifecourse among biracial adults, 2) To use the applicant's research as a platform for the mentorship of patient-oriented researchers in the epidemiology of cognitive aging and 3) To enable the applicant to pursue new research directions and to continue to support her development as an internationally recognized mentor for trainees from a wide range of disciplines interested in cognitive aging. During the first 5 years of support provided by the K24 award, Dr. Yaffe has been both a very productive mentor and independently funded investigator. During this period, she has obtained eight patient-oriented research grants (3 R01s, 2 Project Cores on Program Projects from NIH, an Investigator-Initiated Research Grant from the Alzheimer's Association, a Department of Defense grant and an American Health Foundation grant). Over the initial K24 project period from 2007 to 2012, Dr. Yaffe has served as primary or secondary mentor to 19 trainees in a wide range of disciplines and at various levels of training. Dr. Yaffe's long-term goals are to become an international leader in aging research, to contribute substantially to our understanding and approaches to the treatment and prevention of cognitive impairment and to mentor the next generation of investigators interested in the epidemiology of cognitive aging. This one-time renewal of a mid-career development award will help her to reach these goals.